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MDCT findings of aortic branch artery pseudoaneurysms associated with type B intramural haematoma

S Seitun1, U G Rossi, F Cademartiri

  • 1UOC Radiodiagnostica e Radiologia Interventistica, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Monoblocco 1-F, Largo Rosanna Benzi 10, 16132, Genova, Italy. saraseitun@yahoo.com

La Radiologia Medica
|January 10, 2012
PubMed
Abstract

Insights

Aortic branch artery pseudoaneurysms linked to type B aortic intramural hematoma (IMH) are often benign, with most cases resolving or stabilizing. Close follow-up is still essential due to potential early changes.

Area of Science:

  • Vascular Surgery
  • Radiology
  • Cardiovascular Imaging

Background:

  • Type B aortic intramural hematoma (IMH) is a variant of aortic dissection.
  • Branch artery pseudoaneurysms can be a complication of aortic pathologies.
  • Understanding their behavior in IMH is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence and characteristics of aortic branch artery pseudoaneurysms in type B IMH.
  • To evaluate the natural evolution of these pseudoaneurysms using multidetector computed tomography (MDCT).
  • To assess the clinical significance and management implications of these findings.

Main Methods:

  • Retrospective analysis of 14 patients diagnosed with acute type B IMH without intimal tears.
  • Utilized multidetector computed tomography (MDCT) for initial diagnosis and follow-up.
  • Clinical and MDCT follow-up was performed for all enrolled patients.

Main Results:

  • Pseudoaneurysms were identified in 43% of patients (6/14), with most being multiple (83%).
  • The descending thoracic aorta branches, particularly intercostal arteries, were most commonly involved.
  • Over a mean follow-up of 10.6 months, 95% of pseudoaneurysms showed resolution, size reduction, or stability.

Conclusions:

  • Aortic branch artery pseudoaneurysms associated with type B IMH appear to follow a generally benign course.
  • The majority resolve or remain stable, suggesting favorable outcomes with hematoma resorption.
  • Despite the benign trend, dynamic changes necessitate close clinical and imaging surveillance.

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